tbuckley/cabot-search huggingface dataset:
Postoperative care in open-heart surgery
Authors: E. A. Moffitt
Journal: JAMA (1967)

Experience at the Mayo Clinic with whole-body perfusion in open, intracardiac surgery indicates that, although such perfusion is a major deviation from normal physiology, it is remarkably well tolerated. Detrimental changes in tissue and organ function, however, are taking place and are directly related to the length of perfusion. These changes, along with the severity of the disease necessitating operation and the surgical success in correcting that disease, are the major determinants of survival.
Abstract P260: Patients Experiencing Homelessness Have Longer Hospital Lengths of Stay After Admission for Ischemic Stroke or TIA
Authors: Leslie Corless, Lindsay Lucas, Elizabeth Baraban
Journal: Circulation (2017)

Introduction: There is little information available regarding stroke care and outcomes specific to patients experiencing homelessness. This study assesses the provision of stroke care and outcomes for these patients and identifies opportunities to improve their care. Methods: Data was obtained from a large, multi-state health system’s Get With The Guidelines registry for patients discharged between January 2009 and September 2016. Patients with an ischemic stroke or transient ischemic attack (TIA) were included. Patients with time of last known well (LKW) to hospital arrival of more than two weeks or hospital arrival to CT times of more than two days were excluded. Homeless patients were matched to non-homeless patients with a 1:5 ratio using case control matching on age, stroke type, gender and year. Patient characteristics between homeless and housed patients were compared before and after matching using t-tests, Mann Whitney tests, or chi-squared tests, as appropriate. Primary outcomes were discharge modified Rankin score (mRs), with disability categorized as none/slight (mRs≤2) or moderate or greater (mRS &gt; 3) and length of stay (LOS). Logistic regression was used to analyze the relationship between homeless status and mRs, and Cox proportional hazards regression was used to assess the effect of homelessness on LOS. LKW to hospital arrival time and admit National Institutes of Health Stroke Scale (NIHSS) score were added as covariates to both models. Adjusted odds ratios (AOR) and hazards ratios (AHR), and their corresponding p-values were reported. Results: A total of 20,516 patients met inclusion criteria with 28 experiencing homelessness. Prior to matching, homeless patients were more likely to be male (78.6% vs 48.9%, p=.007), younger (58 vs 72 years, p&lt;.001) and have longer median LKW to arrival times (921 vs 386 minutes, p=.066). After matching, the analytic sample size was 168 patients with 16.7% (n=28) experiencing homelessness and 83.3% (n=140) housed. Multivariable analyses indicated that homeless patients leave the hospital at a slower rate compared to the non-homeless (AHR=0.666, p=.056). They also had lower disability scores at discharge (AOR=0.104, p=.095); however, this result only approached significance. Conclusion: Patients experiencing homelessness had longer LKW to hospital arrival times indicating an opportunity for targeted intervention around the need for quick arrival after symptoms. In addition, homeless patients also had longer LOS which is likely related to challenges in safely discharging this population. Further research with a larger number of patients is needed in order to compare other aspects of acute stroke care, including treatment rates and time to treatment, and assess ways to address the challenges of shortening last known well to arrival times and safe discharge.
Plasma Jet Takes off
Authors: Lance Frazer
Journal: Environmental Health Perspectives (1999)

Thanks to a series of joint research projects by Los Alamos National Laboratory, Beta Squared of Allen, Texas, and the University of California at Los Angeles, there is now a more environmentally sound method for cleaning semiconductor chips that may also be effective in cleaning up chemical, bacterial, and nuclear contaminants. The Atmospheric Pressure Plasma Jet uses a type of ionized gas called plasma to clean up contaminants by binding to them and lifting them away. In contrast to the corrosive acids and chemical solvents traditionally used to clean semiconductor chips, the jet oxidizes contaminants, producing only benign gaseous by-products such as oxygen and carbon dioxide. The new technology is also easy to transport, cleans thoroughly and quickly, and presents no hazards to its operators.
<i>QuickStats</i>: Percentage of Adults Aged ≥45 Years with Activity Limitations, by Age Group and Type of Limitation* — National Health Interview Survey,† United States, 2000–2015
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

The percentage of adults aged 45-64 years with limitations in activities of daily living (ADLs) increased from 1.3% in 2000 to 2.0% in 2015, and the percentage with limitations in instrumental activities of daily living (IADLs) increased from 2.8% to 4.0%. Among adults aged ≥65 years, the percentage with limitations in ADLs increased from 6.4% to 6.9%, and the percentage with limitations in IADLs decreased from 12.9% to 11.7%.
Heart
Authors: Paula Tatarunis
Journal: Annals of Internal Medicine (1999)

Ad Libitum5 October 1999HeartPaula Tatarunis, MDPaula Tatarunis, MDWaltham, MA 02453 (Tatarunis)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-7-199910050-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Oh master of enjambement, blank verseis what we wake to, wordless, and what lullsus sleepward, sometimes, sometimes frightens usawake, alert for a faltering, skip,the catalectic heralding anasystole, a dactylic gallop totrochees of misbuilt tensions, and flaccidanapests that signal failure, murmurs, clicks,the tachycardias of angst, the dulland bradycardic spondees dirging homewardthrough the final room, valve, ear, door(Lub-dub's iambic lullaby? No more.) Author, Article, and Disclosure InformationAffiliations: Waltham, MA 02453 (Tatarunis)Corresponding Author: Paula Tatarunis, MD, 23 Willow Street, Waltham, MA 02453. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 5 October 1999Volume 131, Issue 7Page: 538KeywordsHeartTachycardia Issue Published: 5 October 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
ANTISTREPTOCOCCUS SERUM
Authors: GEORGE H. WEAVER
Journal: JAMA (1913)

In the protection of the animal body against virulent streptococci two factors are known to be of importance. The bacteria are first acted on by opsonin, which is found especially in the blood-serum, and thus prepared for phagocytosis by the leukocytes in which they are destroyed. The normal body usually possesses sufficient antistreptococcic power for its protection against streptococci as they occur on the mucous membranes, tonsils, etc. If the normal resistance is lowered, or an unusual number or highly virulent bacteria gain entrance to the body through some defect in the protective mechanism, the bacteria may multiply and produce disease. When such an infection runs a favorable course the streptococci stimulate the body cells to produce immune opsonin which in turn acts on the streptococci and prepares them for phagocytosis and destruction by the leukocytes. A coincident increase of leukocytes also heightens the power of the body to destroy
Long-term cloprednol use in chronic asthma
Authors: U. D. Gavani
Journal: JAMA (1979)

Cloprednol is an oral synthetic glucocorticoid with a short serum half-life of 110 minutes. Twenty children who had chronic corticosteroiddependent asthma were empaneled to study the effects of cloprednol for a period of 24 months. Three of these dropped out at the end of one year. Alternate-day doses of prednisone were replaced by equivalent daily 8 am doses of cloprednol. Ten of 17 patients had better control during cloprednol therapy than during previous prednisone regimens, and significant improvement was noted in peak expiratory flow rate during the study period (<i>P</i>&lt;.001). Long-term side effects were absent. Improvement in the degree of hypothalamopituitary adrenal axis responsiveness, based on fasting 8 am cortisol levels, was noted from baseline to the end of study period. (<i>JAMA</i>242:2679-2682, 1979)
Cancer Downwind from Sour Gas Refineries: The Perception and the Reality of an Epidemic
Authors: Martin T. Schechter, Walter O. Spitzer, Marian E. Hutcheon, Robert E. Dales, Lily M. Eastridge, Nicholas Steinmetz, Pierre Tousignant, Charlotte Hobbs
Journal: Environmental Health Perspectives (1989)

A rural population in southwestern Alberta, Canada, living downwind from natural gas refineries, has expressed concerns about an excess of adverse health outcomes over the last 25 years. This has escalated to the point of causing a prominent sociopolitical controversy within the province. As part of a large field epidemiologic study undertaken during the summer of 1985 to investigate possible health effects, a residential cohort study was carried out to study cancer incidence. The cohort was defined as all those individuals who resided in the area in 1970. A total of 30,175 person-years of risk within Alberta were experienced by this cohort from 1970 to 1984. The incident cancers during this period were enumerated by computerized record linkage with the Alberta Cancer Registry. Age- and sex-standardized incidence ratios, based on expected rates from three prespecified demographically similar, nonmetropolitan Southern Alberta populations, were 1.05, 1.09, and 1.03, respectively, none of which was significantly different from unity. Although they do not address the issue of etiologic association, these data can provide considerable reassurance to a community that was convinced it had experienced an epidemic of cancer.
Neoadjuvant Chemotherapy and Radical Surgery Versus Exclusive Radiotherapy in Locally Advanced Squamous Cell Cervical Cancer: Results From the Italian Multicenter Randomized Study
Authors: Pierluigi Benedetti-Panici, Stefano Greggi, Alessandro Colombo, Mariangela Amoroso, Daniela Smaniotto, Diana Giannarelli, Gianni Amunni, Francesco Raspagliesi, Paolo Zola, Costantino Mangioni, Fabio Landoni
Journal: Journal of Clinical Oncology (2002)

Neoadjuvant chemotherapy (NACT) and radical surgery (RS) have emerged as a possible alternative to conventional radiation therapy (RT) in locally advanced cervical carcinoma. In 1990, a phase III trial was undertaken to verify such a hypothesis in terms of survival and treatment-related morbidity.Patients with squamous cell, International Federation of Gynecology and Obstetrics stage IB2 to III cervical cancer were eligible for the study. They received cisplatin-based NACT followed by RS (type III to V radical hysterectomy plus systematic pelvic lymphadenectomy) (arm A) or external-beam RT (45 to 50 Gy) followed by brachyradiotherapy (20 to 30 Gy) (arm B).Of 441 patients randomly assigned to NACT+RS or RT, eligibility was confirmed in 210 and 199 patients, respectively. Treatment was administered according to protocol in 76% of arm A patients and 72% of arm B patients. Adjuvant treatment was delivered in 48 operated patients (29%). There was no evidence for any significant excess of severe morbidity in one of the two arms. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 58.9% and 55.4% for arm A and 44.5% and 41.3% for arm B (P =.007 and P =.02), respectively. Subgroup survival analysis shows OS and PFS rates of 64.7% and 59.7% (stage IB2-IIB, NACT+RS), 46.4% and 46.7% (stage IB2-IIB, RT) (P =.005 andP =.02), 41.6% and 41.9% (stage III, NCAT+RS), 36.7% and 36.4% (stage III, RT) (P =.36 and P =.29), respectively. Treatment had a significant impact on OS and PFS.Although significant only for the stage IB2 to IIB group, a survival benefit seems to be associated with the NACT+RS compared with conventional RT.
Reconnecting
Authors: Stephen T. Harvey
Journal: JAMA (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Erratum to: Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study
Authors: Sara Nisula, Kirsi-Maija Kaukonen, Suvi T. Vaara, Anna-Maija Korhonen, Meri Poukkanen, Sari Karlsson, Mikko Haapio, Outi Inkinen, Ilkka Parviainen, Raili Suojaranta-Ylinen, Jouko J. Laurila, Jyrki Tenhunen, Matti Reinikainen, Tero Ala-Kokko, Esko Ruokonen, Anne Kuitunen, Ville Pettilä
Journal: Intensive Care Medicine (2013)
State-Specific Cholesterol Screening Trends--United States, 1991-1999
Journal: JAMA (2000)

High blood cholesterol (HBC) increases the risk for heart disease, the leading cause of death in the United States. To reduce the prevalence of HBC in the United States, the National Heart, Lung, and Blood Institute initiated the National Cholesterol Education Program in 1985 and recommended that all adults aged > or =20 years have their cholesterol levels checked at least once every 5 years. One of the national health objectives for 2000 was to increase to 75% the proportion of adults aged > or =20 years screened for HBC during the preceding 5 years (objective 15.14). This objective was revised for 2010 to recommend that 80% of adults in this age group be screened during the preceding 5 years. To monitor progress during the 1990s and to determine whether the 2000 objective was attained, data from CDC's Behavioral Risk Factor Surveillance System (BRFSS) were used to examine the state-specific trends in cholesterol screening from 1991 through 1999. This report summarizes the results of this analysis and provides a projected estimate of the 2010 screening rates for HBC in each state. The findings indicate that few states attained the 2000 objective and that more emphasis on cholesterol screening will be needed to attain the 2010 objective.
Harry Goldblatt: 1891-1977
Authors: L. B. Berman
Journal: JAMA (1977)

The recent death of Harry Goldblatt bids us to pause and reflect on the affairs of men. The Nobel Prize committee is likely to continue its policy of not asking me for suggestions but I, unabashed, offer Dr Goldblatt's name. The experiment that gave rise to the eponymic kidney is well known, but his reasons for clamping the renal artery and the unexpected consequences may bear a brief retelling. Goldblatt's passion was to find the cause of essential hypertension. As a young pathologist, he was greatly taken with the thought that nephrosclerosis is a primary disease that leads to hypertension. His problem was that the experimental production of nephrosclerosis in a normotensive animal is impossible, but there might be an analogy between the kidney with nephrosclerosis and a kidney with a tiny clamp on each afferent arteriole. He wondered if partially occluding both main renal arteries with large clamps would
Point: Active Surveillance for Favorable Risk Prostate Cancer
Authors: Laurence Klotz
Journal: Journal of the National Comprehensive Cancer Network (2007)

Active surveillance for favorable risk prostate cancer has become increasingly popular in populations where prostate cancer screening is widespread, because of evidence that prostate cancer screening results in the detection of disease that is not clinically significant in many patients (i.e., untreated, would not pose a threat to health). This approach is supported by data showing that patients who fall into the category of clinically insignificant disease can be identified with reasonable accuracy, and that patients who are initially classified as low-risk who reclassify over time as higher-risk and are treated radically are still cured in most cases. Active surveillance means 1) identifying patients who have a low likelihood of disease progression during their lifetime, based on clinical and pathologic features of the disease, and patient age and comorbidity; 2) close monitoring over time; 3) developing reasonable criteria for intervention, which will identify more aggressive disease in a timely fashion and not result in excessive treatment; and 4) meeting the communication challenge to reduce the psychological burden of living with untreated cancer. This article reviews the results of active surveillance, the criteria for patient selection, and the appropriate triggers for intervention.
Proliferation and hypertrophy of liver cells surrounding islet grafts in diabetic recipient rats
Authors: Monique E. De Paepe, Bart Keymeulen, Daniel Pipeleers, Günter Klöppel
Journal: Hepatology (1995)

The liver offers an adequate site for the metabolic function of pancreatic islet implants. Little is known about the effects of the islet grafts on the host organ. This study examines liver tissue of normal or streptozotocin (STZ)-diabetic rats at different intervals following intraportal injection of syngeneic islets. Implantation of 800-islet—grafts, containing 0.9 million beta cells, normalized overt diabetes within 14 days. This period of metabolic normalization was characterized by a specific sequence of alterations in the implant area. During the first days after transplantation, islet cells migrated into the liver lobules, whereby tight hepatocyte-islet cell contacts were established. Hepatocytes surrounding grafts showed massive lipid accumulation and hypertrophy (cellular profile area 603 ± 72 μm 2 in diabetic islet recipients vs. 382 ± 42 μm 2 in diabetic controls; P &lt; .005). The implant area also contained significantly more liver cells in proliferative activity than hepatic tissue in normal controls (bromodeoxyuridine labeling index of peri-islet hepatocytes 6.2%, 4.6%, and 0.9% on posttransplantation days 2, 4, and 14, respectively, compared with 0.02% in normal controls). The cellular hypertrophy and hyperplasia explain the sudden increase in liver weight of diabetic recipients (from 8.0 ± 1.1 g to 13.8 ± 2.2 g on post-transplantation day 2; P &lt; .005). Both alterations can be attributed to the massive local discharge of insulin in an insulin-deficient organ containing an excess of extracellular nutrients. Progressive revascularization of the implant sites and overall metabolic normalization are thought to explain the return of a normal liver histology by the third week after transplantation. In conclusion, intraportal islet grafts exert profound effects on the liver of diabetic rat recipients. The morphological features of the implant sites may serve as markers for the function of the islet grafts as well as for the adaptive capacity of the recipient liver. (Hepatology 1995; 21:1144-1153.)
Borderline Medicine
Authors: Odin W. Anderson
Journal: JAMA (1991)

In the face of continuing rising expenditures for health services in the United States, the government-financed and -administered health insurance in Canada is receiving a great deal of attention here. There are two reasons for this: in Canada the expenditure for health services has remained quite constant at 8% or so of the gross domestic product (GDP), and all Canadians can receive hospital and physicians' services with no charge at time of service. The differences between the Canadian and the US health services and health insurance have been documented in an hour-long television program,<i>Borderline Medicine</i>, narrated by the veteran TV reporter Walter Cronkite. The presentation is even-handed, with commentaries from health services policy experts from the United States both favorably and unfavorably disposed to the adoption of the Canadian system in this country. The facts presented are correct, such as continuing choice of physicians and hospitals in Canada as
Rates of injury at day-care centers
Authors: H. C. Solomons
Journal: JAMA (1993)

<h3>In Reply.</h3> —We agree with Drs Solomons and Elardo that accurately determining injury rates for children is important. The scope of our article was limited to a description of the published literature and was not intended to be a rigorous critique of the methods of all the studies of injury and infectious diseases. Because we limited our review to published data, we could not, for example, have calculated more precise injury rates from the data provided by several authors, including Solomons and Elardo in their published articles.<sup>1,2</sup>Hence, we chose to provide the most comparable data. Obtaining accurate estimates of both numerator and denominator is difficult. The question of whether to include treatment by paramedics with treatment by physicians is one example of the difficulty in choosing comparable numerators. We believe that the injuries most important to prevent are those that are most severe—those that result in death, permanent
Maternal Arsenic Exposure and Impaired Glucose Tolerance during Pregnancy
Authors: Adrienne S. Ettinger, Ami R. Zota, Chitra J. Amarasiriwardena, Marianne R. Hopkins, Joel Schwartz, Howard Hu, Robert O. Wright
Journal: Environmental Health Perspectives (2009)

Background: Accumulating evidence has shown an increased risk of type 2 diabetes in general populations exposed to arsenic, but little is known about exposures during pregnancy and the association with gestational diabetes (GD).oBjectives: We studied 532 women living proximate to the Tar Creek Superfund Site to investigate whether arsenic exposure is associated with impaired glucose tolerance during pregnancy.Methods: Blood glucose was measured between 24 and 28 weeks gestation after a 1-hr oral glucose tolerance test (GTT) as part of routine prenatal care.Blood and hair were collected at delivery and analyzed for arsenic using inductively coupled plasma mass spectrometry with dynamic reaction cell.results: Arsenic concentrations ranged from 0.2 to 24.1 µg/L (ppb) (mean ± SD, 1.7 ±1.5) and 1.1 to 724.4 ng/g (ppb) (mean ± SD, 27.4 ± 61.6) in blood and hair, respectively.One-hour glucose levels ranged from 40 to 284 mg/dL (mean ± SD, 108.7 ± 29.5); impaired glucose tolerance was observed in 11.9% of women when using standard screening criterion (> 140 mg/dL).Adjusting for age, Native-American race, prepregnancy body mass index, Medicaid use, and marital status, women in the highest quartile of blood arsenic exposure had 2.8 higher odds of impaired GTT than women in the lowest quartile of exposure (95% confidence interval, 1.1-6.9)(p-trend = 0.008).conclusions: Among this population of pregnant women, arsenic exposure was associated with increased risk of impaired GTT at 24-28 weeks gestation and therefore may be associated with increased risk of GD.